How Does Dexamethasone Help with Coronavirus?
Treatments for COVID-19 appear to be helping shorten the days in the hospital for many patients. We have heard about the high percentage of seriously ill coronavirus patients that died on ventilators. Those headlines appear less often today. Why?
COVID-19 Treatment
There are many treatments for COVID-19. For most of us, over 95% of us, we are sent home and self-quarantine is the treatment. We isolate ourselves from others and allow our immune system to heal us.
For those few percentages of people unfortunate enough to end up in the hospital, doctors are using a variety of options depending specifically on symptoms and pre-existing conditions.
Dexamethasone, remdesivir, EIDA-2801, favipiravir, Kaletra, merimepodib are antiviral agents available. Monoclonal antibody and convalescent plasma are also being used in some cases. Immune modulation and hydroxychloroquine are other options used in the treatment of COVID-19.
The hospital and medical team make the decisions for their patients. The headlines this past week included the drug, dexamethasone, as a treatment. What is important about this drug? https://www.foxnews.com/health/what-is-dexamethasone-the-newest-drug-in-trumps-covid-19-treatment.
Dexamethasone
Steroids are used to improve oxygen flow in seriously ill patients and reduce or suppress the uncontrolled immune response that sometimes appears with COVID-19. Dexamethasone, hydrocortisone, and methylprednisolone are several steroids (corticosteroids) used to reduce lung inflammation when patients need supplemental oxygen.
These drugs are considered safe, inexpensive, and easily available. In several CODID-19 studies, the mortality rate is lower as seen in the World Health Organization (WHO) Rapid Evidence Appraisal for COVID-19 Therapies (REACT) studies. https://www.cidrap.umn.edu/news-perspective/2020/09/studies-who-back-steroid-use-very-ill-covid-19-patients.
A very recent clinical study (the Randomized, Embedded, Multifactorial Adaptive Platform Trial for Community-Acquired Pneumonia – REMAP-CAP)of corticosteroids used to treat COVID-19 patients was published in JAMA (the Journal of the American Medical Association) showed a 93% increase in survivability and the less overall need for supplemental oxygen.
Some drugs work well on some patients and not well on others. Corticosteroids help improve patient recovery and are used when warranted. Other studies with published results in France and Brazil show similar successful results.
Side Effects
All drugs have side effects. Two different people could have the same side effect and one effect might be mild or near-lethal depending on the individual. It is like the asymptomatic COVID-19 patients who show no symptoms whatsoever and are still infected with the virus.
Side effects for corticosteroid patients could include changes in mood, behavioral, or cognitive ability – both short-term and long-term. Stomach irritation, nausea, headaches, dizziness, and more are also typical. Because corticosteroid suppresses the immune system, extra care must be taken in recovery to prevent the occurrence of other infections.
Side effects should be monitored, especially insomnia, anxiety, depression, and more depending on the dosage amount and the total number of times the drug was given. In most cases, side effects from drugs (in general) go away after use. Some drugs, if used for longer times, might present withdrawal symptoms that can last for a week or longer.
Conclusion
It is not a simple matter of declaring that this drug has these side effects. When multiple drugs are used in concert, what are the combined effects? In most cases, no one knows how drugs interact with each other.
Clinical trials are not set up to track the efficacy, effectiveness, and side effects of combined treatments. This is one reason why vaccines will have a wide variety of health issues when given to treat the COVID-19 pandemic.
Doctors track the recovery of patients to ensure that side effects are monitored,
and subsequent action can be taken if needed.
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